| Objective:Through a retrospective study,to explore the risk factors of radiation proctitis,to understand its role in the development of the disease,to provide the basis for individualized treatment,and to systematically evaluate the treatment of radiation proctitis with retention enema of integrated traditional Chinese and Western medicine,so as to provide a certain scientific basis for its clinical efficacy,reduce the incidence and mortality of the disease,and effectively guide the clinical treatment of patients and doctors Bed prevention and treatment.Methods:1.Risk factors of radiation proctitisTo collect the clinical data of patients with radiation proctitis in Shanxi Provincial Hospital of traditional Chinese medicine and Shanxi Provincial Cancer Hospital from January 1,2015 to December 30,2020,and describe the characteristics of the population;at the same time,through the way of case grouping control study,single factor analysis was conducted on the risk factors of radiation proctitis,and logistic regression analysis was conducted on the single factor with statistical significance The independent risk factors were screened by element analysis.2.Systematic review of retention enema of integrated traditional Chinese and Western medicine in the treatment of radiation proctitisThrough the development of search strategy,we systematically and comprehensively searched the high-quality randomized controlled trials clinical research literature of integrated traditional Chinese and Western Medicine Retention Enema in the treatment of radiation proctitis from CNKI,Wanfang database,VIP,Pub Med,EMBASE,central,MEDLINE and other databases from the establishment of the database to December 2019 Objective to evaluate the effectiveness of retention enema in the treatment of radiation proctitis by combining traditional Chinese and Western medicine.Results:1.The population characteristics of radiation proctitis are as follows(1)General information: female is higher than male,the ratio of male to female is1:19.545;the average age is 58.67 ± 10.74 years old;the average height is 157.73 ±6.93cm;the average weight is 59.95 ± 9.91kg;long-term residence is mainly in Taiyuan,Xinzhou and Luliang;occupation is mainly farmers,accounting for 77%.(2)Menstruation and childbearing history: in this study,215 women,the average age of menarche was 15.24 ± 1.821 years old;the average age of amenorrhea was 49.29 ± 4.73 years old,the menstrual cycle and menstrual period were normal;the average number of pregnancies was 3.81 ± 1.656 times,the average number of deliveries was 3.15 ± 1.352times;(3)Previous medical history was mainly hypertension,gastric ulcer,cervicitis and pelvic inflammatory disease;(4)The normal diet is mainly high salt,high fat,pickled food,spicy food,sweet food,leftovers and irregular meals;(5)Cervical cancer was the main primary tumor,accounting for 88.5%.Squamous cell carcinoma was the main pathological type,accounting for 78.8%.85.8% patients did not receive surgical treatment.57.5% patients received concurrent chemoradiotherapy.88.9%patients received intracavitary irradiation.The average total dose of intracavitary irradiation was 34.353 ± 9.578 gy,the average number of intracavitary irradiation was5.667 ± 1.836,and the average total dose of radiotherapy was 54.653 ± 18.332 gy,The average fractionated dose was 2.065 ± 0.414gy;(6)Syndrome differentiation and treatment of traditional Chinese medicine to cold and heat mixed syndrome is the most,followed by spleen and kidney yang deficiency syndrome,spleen deficiency and dampness stagnation syndrome,heat toxin injury,collateral syndrome accounted.2.The independent risk factors were age,height,high salt diet,high fat diet,sweet food,previous intestinal polyps,hypertension,total dose of radiotherapy and total dose of intracavitary irradiation,which may be the independent risk factors of radiation proctitis in cervical cancer(P < 0.05).3.The results of meta analysis showed that: 1(1)Clinical efficacy: the retention enema group was better than the simple western medicine enema or blank enema Group [OR=6.94,95% CI(5.39,13.00),P < 0.000 1];(2)Improvement of abdominal pain: the retention enema group was better than the control group [MD=–0.57,95% CI(–0.72,–0.42),P < 0.000 01];(3)Treatment of hematochezia: the retention enema group was better than the control group [MD=–0.42,95% CI(–0.46,–0.37),P < 0.000 01];(4)Improvement of diarrhea: the retention enema group was better than the control group [MD=–0.60,95% CI(–0.78,–0.42),P < 0.000 01];(5)KPS score: the integrative medicine retention enema group was better than the control group [MD=10.58,95% CI(4.35,16.81),P < 0.000 01].Conclusion:1.The population characteristics of radiation proctitis are: women,cervical cancer,farmers,and most of them have not received surgical resection treatment.Most of them have received concurrent chemoradiotherapy and intracavitary irradiation.Most of them have suffered from hypertension,cervicitis,pelvic inflammatory disease and gastric ulcer in the past.They usually eat high salt,high fat,pickled food,spicy food,sweet food,leftovers and irregular meals The syndrome differentiation of traditional Chinese medicine is mainly based on the syndrome of heat toxin injuring collaterals and the syndrome of mixed cold and heat.2.When the patient is treated with both external and internal radiation therapy,we should be alert to the occurrence of radiation proctitis;previous intestinal polyps,hypertension history and diabetes history are independent risk factors for radiation proctitis in patients with cervical cancer;high salt diet,high fat diet and sweet food may induce radiation The occurrence of proctitis.3.The clinical effect of retention enema with integrated traditional Chinese and Western Medicine on radiation proctitis is better than that of simple western medicine enema or blank enema. |
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